Indiana FSSA Medicaid · October 24, 2026 · Primary source
BT2026173
Summary
The Indiana Health Coverage Programs issued Bulletin BT2026173 on October 15, 2026, announcing a system change to discontinue rate adjustments based on provider type or specialty for Medicaid Rehabilitation Option, Adult Mental Health Habilitation, Behavioral and Primary Healthcare Coordination, and Child Mental Health Wraparound programs. Going forward, all MRO, AMHH, BPHC, and CMHW claims will be reimbursed at 100 percent of the IHCP Professional Fee Schedule amount. Claims previously reimbursed at less than 100 percent will be considered for reprocessing, with a supplemental bulletin to follow.
What this may mean
Providers billing Indiana Medicaid for MRO, AMHH, BPHC, and CMHW behavioral health services will receive 100 percent of the Professional Fee Schedule rate going forward, eliminating prior reductions tied to provider type or specialty. Previously underpaid claims are subject to reprocessing, and providers must stop reporting specialty or qualification modifiers on these claim lines.
Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.
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